Carbohydrate-Based Vaccines - American Chemical Society

Chapter 8

A Uniquely Small, Protective Carbohydrate Epitope May Yield a Conjugate Vaccine for Candida albicans 1,

1,2

1

David R. Bundle *, M. Nitz , Xiangyang Wu , and Joanna M. Sadowska 1

Downloaded by MIT on May 21, 2013 | http://pubs.acs.org Publication Date: July 2, 2008 | doi: 10.1021/bk-2008-0989.ch008

1

2

Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada Current address: Department of Chemistry, University of Toronto, 80 St. George Street, Toronto, Ontario M5S 3H6, Canada

The cell wall phosphomannan of C. albicans is a promising target for the induction of immunity by development of a conjugate vaccine. It contains a unique antigen, a β1,2-mannan that affords active protection to mice following immunization and subsequent challenge with live organisms. Disaccharide and trisaccharide fragments of the β1,2-mannan antigen optimally inhibit two murine monoclonal antibodies that confer protection in a mouse model of candidiasis implying that epitopes of this size might constitute viable vaccine components. Short oligosaccharides conjugated to suitable immunogenic proteins have been synthesized by two distinct approaches one of which is well suited to multigram synthesis. Tetanus toxoid was chosen as a carrier protein for its ability to induce a vigorous hapten specific IgG response and for compatibility with human vaccine applications. Preliminary data show that rabbits immunized three times with a trisaccharide glycoconjugate produce sera with ELISA titers of 1:500,000 for the Candida albicans cell wall mannan. These rabbit antibodies also bind the antigen when it is present on the fungal cell wall. Only slightly lower antibody responses to the trisaccharide epitope were observed when 2 injections of these tetanus toxoid conjugates was performed with alum, an adjuvant acceptable for use in humans.

© 2008 American Chemical Society

In Carbohydrate-Based Vaccines; Roy, R.; ACS Symposium Series; American Chemical Society: Washington, DC, 2008.

163

164


Introduction Carbohydrate antigens occupy an enigmatic role with respect to the mammalian immune system but have nevertheless played a significant role in the development of the disciplines of immunochemistry and practical aspects of immunology (7-5). The identification of the carbohydrate epitopes of the human ABO blood groups established that the specificity of carbohydrate-antibody interactions could be, in the case of a mismatched blood transfusion, a life threatening situation. On the other hand, immunization with the capsular polysaccharides antigens of pneumococcal or meningococcal bacteria induced antibody that at least for adults conferred life saving immunity against these potentially deadly bacterial infections (4,5). Subsequent work on the cells and molecules of the mammalian immune system that are responsible for processing antigens has shown that the limited immunogenicity of carbohydrate antigens is directly related to the manner in which antigens are presented by specialized immunocompetent cells (6). The immune system is highly evolved and tailored to process protein antigens into peptidefragmentswhich are then bound to MHC molecules that present the peptide to T-cell receptors (7,8), thereby initiating a cascade of signals that instruct B-cells to secrete antibody of increasing affinity (6). The T-cell independent nature of polysaccharide antigens is explained by this finding, which also logically leads to the concept of carbohydrate conjugate vaccines. When polysaccharides and oligosaccharides are colavently linked to immunogenic carrier proteins such as Diptheria toxin or tetanus toxoid (5,9,10) antigen processing creates T-cell peptides from the carrier protein. These peptides when presented to T-cells by MHC molecules recruit T-cell help that results in an antibody response to the carbohydrate epitope of the conjugate. Furthermore this immune response can be boosted by a second injection, in which case it is said to exhibit secondary response characteristics such as antibody class switch, including affinity maturation (6). Commercial conjugate vaccines of this type have been widely adopted in the last two decades and are highly effective in reducing the incidence of diseases caused by Haemophilus influenzae, Neisseria meningitis and Streptococcus pneumoniae (11). Recently a significant break through was reported for Haemophilus influenzae vaccine. The carbohydrate capsular antigen component of this conjugate vaccine that originated from bacterial fermentation was substituted by a totally synthetic oligosaccharide (12). In this way a fully semi-synthetic conjugate vaccine was prepared from an oligomeric H influenzae heptameric construct conjugated to tetanus toxoid. The resultant vaccine was demonstrated to be as effective as the polysaccharide-protein conjugate (12). We report here preliminaryfindingsthat suggest a uniquely small, synthetic trisaccharide epitope conjugated to tetanus toxoid will be sufficient to secure recognition of the β-mannan of the Candida albicans cell wall phosphomannan



165 complex and eventually a protective immune response against Candida infections. A conjugate vaccine composed of a carbohydrate epitope consisting of only 3 hexose residues would be a radical departure from previously held views regarding the minimum size of protective epitopes (75). Several lines of evidence have suggested that the saccharide component of conjugate vaccines should consist of multiple repeating units ranging in size from 8 up to 200 saccharide residues (13-16). If it proved immunologically active, a trisaccharide epitope for a Candida conjugate vaccine would not only be a significant break with conventional wisdom but would also be highly desirable from the perspective of the economics of chemical synthesis. In this paper we also report the potential utility of oligosaccharides in which the glycosidic oxygen atom bridging adjacent hexose residues may be exchanged for sulphur without significance loss of the fidelity of binding to native O-linked antigens. It could be envisaged that terminally linked sugar residues attached by such metabolically stable linkages would, in special circumstances, provide glycosidase resistant epitopes that might otherwise be susceptible to endogenous glycosidases (7 7,75). Candidate vaccines to treat fungal infections are the focus of growing intetest for a variety of reasons. Candida albicans is the most common etiologic agent in candidiasis, a serious infection with high morbidity rates especially for immunocompromised patients (19-21). Immunotherapeutic strategies to increase host resistance are now attracting attention since antifungal agents with excellent in vitro activity have significant toxicity issues (22). A unique pl,2-mannan antigen present in the cell wall phosphomannan of C. albicans is a promising target for the induction of protective immunity (Figure 1). Cutler's group showed that immunization with a conjugate vaccine prepared from the pl,2-mannan antigen conferred active and passive protection in a mouse model of disseminated candidiasis (23,24) and also that passive protection could be achieved with two monoclonal antibodies raised to similar antigen preparations (25,26). Employing a series of oligosaccharides from di- up to hexasaccharide we investigated the binding specificity of the two monoclonal antibodies from Cutler's group by inhibition of their binding to immobilized native mannan (Figure 2). The surprising data showed that synthetic disaccharide and trisaccharide fragments of the β 1,2-mannan antigen were optimal inhibitors for these monoclonal antibodies, while larger structures were significantly less active in the order tetrasaccharide> pentasaccharide>hexasaccharide (27). We also noted that a tetrasaccharide derivative in which the terminal hexose was attached via a thio linkage gave better inhibition than the corresponding O-linked tetrasaccharide. These observations are a dramatic departure from a paradigm that has held sway for over 30 years. Kabat had demonstrated that human sera raised against dextran, the α 1,6 linked polymer of glucose, exhibited specificity for oligosaccharides of glucose that increased with the size of the oligo-


166


a-Man(1 -6)a-Man(1 -6)a-Man(1 -6)a-Man(1 -6)a-Man(1 -6)a-Man(1 -6)-inner core-Asn

P-Mannan

Figurel. Gross structure of the C. albicans phosphomannan illustrating the two types ofβ-mannan, one attached to the a-mannan via phosphodiester and via a glycosidic linkage of a-mannan side chains.

saccharide (2, 28). Although tri- and tetrasaccharide were frequently very effective inhibitors there was a universal trend in which inhibitor power increased with the size of the oligosaccharide generally reaching a maximum when the size of the oligosaccharide approached hexa- to octasaccharide. Although many different oligosaccharide and antibody systems have been studied since Rabat's initial work, it has always been observed that inhibitory power either increased with hapten molecular weight or remained constant on a molar basis, and to the best of our knowledge we are unaware of any study that showed a significant reduction in binding as inhibitor length increased between 3-6 hexose residues. Since a trisaccharide appears to fill the binding site of the protective antibodies (27) we reasoned that a synthetic conjugate vaccine composed of short oligosaccharides ranging in size from hexasaccharide to perhaps as small as a trisaccharide epitope should be capable of raising antibodies that bind native phosphomannan and possibly offer a viable, chemically defined, cost effective, conjugate vaccine. We now report the efficient synthesis of these oligosaccharides epitopes and immunochemical data for rabbits that have been immunized with such oligosaccharide conjugate vaccines.



167

I

I 1 I I 1I

10

I

I I — ι

ι ι ι 11

ι

ι

ι

ι ι ι ι 11

100

ι

1—I

I I I

1000

inhibitor concentration [μΜ]

Figure 2. ELISA ihibition by synthetic oligosaccharides for the mouse IgG monoclonal antibody C3.1. • propyl ( 1 -»2)-P-D-marmopyranobioside, A propyl ( 1 ->2)-P-D-mannopyraontrioside, Τ propyl ( 1 -thio-p-D-mannopyranosyl)-( 1 ->2)-β-0mannopyranotrioside, • propyl ( 1 ->2)-p-D-mannopyranotetroside, • propyl ( 1 ->2)-p-D-mannopyranopentoside, • propyl ( 1 ->2)^-D-mannopyranohexoside.


168


Synthesis of Oligosaccharide Epitopes The ulosyl bromide 1 introduced by Lichtenthaler's group for βmannopyranoside synthesis was investigated for its utility in the synthesis of β 1,2 mannan oligomers (29). This glycosyl donor reacted stereospecifically with the acceptor 2 to afford a β-linked disaccharide 3, which was subsequently reduced stereoselectively by L-selectride to give the manno configuration and hence the required disaccharide 4 (Scheme 1). The conditions employed for disaccharide synthesis failed to yield significant amounts of trisaccharide when donor 1 was reacted with acceptor 4. Exploration of different activation protocols resulted in the use of the soluble promoter, silver triflate, with 2,6-di-te^butyl-4-methylpyridine (DtBMP) as an acid scavenger, and acetonitrile as a participating solvent. These conditions followed by similar L-Selectride mediated reduction gave a 40-45% yield of trisaccharide 5, and 10% yield of the oc-gluco epimer 6 together with a significant portion of 3,4-di-0-benzyl-l,6-anhydro-P-D-mannopyranose 7. It was hypothesized that the glycosyl donor reacts with acetonitile to yield an ocnitrilium intermediate and that intramolecular cyclizaton gives rise to the anhydrosugar as well as the intended glycosylation product 5 (Scheme 2). Increasing the stability of the ether protecting groups would disfavor intramolecular reaction and the formation of 1,6-anhydro sugar side product and in turn increase the yield of the desired oligosaccharide. The p-chlorobenzyl protecting group was explored for this purpose since it has been shown to be more acid stable than the parent benzyl group but to have otherwise similar properties. The more reactive glycosyl donor 8 afforded trisaccharide intermediates in acceptable yield that were also easier to deprotect (Scheme 3). However, with acetonitile as solvent attempted chain extension of a trisaccharide to give a tetrasaccharide was met by the observation of an interesting and unexpected product. Using the same conditions as those employed to make the trisaccharide, up to 20% of the unexpected 2-O-acetyl trisaccharide acceptor was isolated. We hypothesized that this product resulted from attack of the acceptor on the nitrile carbon of the proposed α-nitrilium intermediate (e.g. pathway b), instead of reaction at the anomeric center of the donor (pathway a). This postulate was supported by the isolation of the chloroacetylated acceptor (11) when chloroacetonitrile was employed as the solvent (Scheme 3). Initial formation of an imidate intermediate (10b) that is hydrolyzed during aqueous work-up accounts for the observed acylated acceptor (11). Literature precedence for this type of intermediate exists (30). In this case the resulting side product must be favored due to a sterically hindered acceptor (9) as well as the electron deficient nitrilium uloside intermediate. When the sterically more hindered pivaloyl nitrile was chosen as the solvent, the glycosidic linkage was synthesized in 48% yield to give the desired tetrasaccharide 13, 10% of the oc-gluco epimer along with



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B n O3—y

OH

OAII Β

Bn

BnO BnO BnO

B

η

n

_

Λ

η

° ^lSÔA.I

0

*~

2

2

\

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(a)

Tu

BnO—ν



6

5 40-45%

Scheme 2. Initial glycosylations indicating a 1,6-anhydrohexose side product indicative of intramolecular cyclization of the activated glycosyl donor intermediate.

-10%



171 small amounts of the trisaccharide pivaloyl ester also being formed (Scheme 4). The glycosyl donor 8 demonstrates high diastereoselectivity over both the glycosylation and subsequent reduction step and minimizes the number of protecting group manipulations necessary for the synthesis. Thus /?-chlorobenzyl protected ulosyl bromide (8) in combination with the sterically hindered, participating solvent, pivaloyl nitrile were considered to be the optimized conditions for this new approach to the synthesis of these unique homooligomers rangingfromdisaccharide up to hexasaccharide (37) (Scheme 4). Congeners of the ( 1 -»2)-P-D-mannotetraose were also synthesized containing a terminal S-linked (l->2)-P-D-mannopyranosyl residue (57) (Scheme 5). The 4,6-O-benzylidene-glucopyranosyl imidate 15 was employed to create a trisaccharide bearing a thiol group at C-2. This was achieved by removal of acetate 16 and conversion of the alcohol 17 to the triflate 18. Displacement with thioacetate gave 19. After conversion to the thiol 20 reaction with 8 followed by reduction of the uloside gave the protected tetrasaccharide 21. An alternate synthetic approach more suited to multi-gram synthesis of oligo-mannan epitopes was developed with the expectation that C. albicans conjugate vaccines of this type could find commercial application (Scheme 6). The synthetic strategy is related to the ulosyl donor method but employs a glucosyl imidate donor 22 with a participating but temporary protecting group at 0-2 (52). The glycosyl imidate 22 gives excellent yields of β-glucopyranosides 23 and 24 under the stereoselective control of the acetyl group. After removal of the acetate group, the 2-hydroxy derivative is oxidized to an uloside which is stereoselectively reduced to the manno configuration. Although the procedure introduces an extra oxidation step, the yields of product are superior and the glucosyl donor 22 is easier to prepare and more stable than either of the ulosyl bromides 1 or 8. In order to functionalize oligosaccharides 9,12,13,14, 21 and 25 to permit conjugation to protein the allyl group of the protected oligosaccharides was subjected to-photochemical addition of cysteineamine prior to removal of the benzyl ether protecting groups (Scheme 7). This created a seven atom tether terminated by an amino group which was reacted either with diethyl squarate (57) or the di-/?-nitrophenyl ester of adipic acid (55). These homo-bifunctional coupling reagents each gave a half ester type intermediate that could be worked up and added directly to the protein to which the oligosaccharide is to be conjugated. Whereas, the squarate activation and coupling appeared to be the most efficient giving rise to conjugates with degree of hapten incorporation of -20-30 with tetanus toxoid (57), the adipic ester approach gave hapten incorporation of -10 haptens per molecule of tetanus toxoid (55). These conjugates were used to immunize rabbits.



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f

Scheme 4. Synthesis of pentasaccharide and hexasaccharide (1 ->2)-fi-D-mannopyranan Oligomers, a) 2, AgOTf DtBMP, (CH ) CCN/CH Cl ; b) L-Selectride THF.

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175 Conjugation to the heterologous protein, bovine serum albumin (BSA) provided conjugates for monitoring the level of anti-hapten antibody response in immunized animals by ELISA. Rabbits were routinely immunized 2 or 3 times with the tetanus toxoid conjugates and the titration of the immune sera is shown in Figures 3 and 4 against both native hapten extracted form C. albicans or oligosaccharide-BSA conjugates. It can be seen that while immunization of rabbits with tetanus toxoid conjugates delivered with the powerful, Freund's adjuvant gave antibody titres in excess of 1,000,000 (Figure 3), just 2 immunizations with a related trisaccharidetetanus toxoid conjugate delivered with alum still gave remarkably high titres in the range 200,000 (Figure 4). This is significant when considering the use of a conjugate vaccine since alum is approved for use in humans while Freund's adjuvant is not suitable for such applications. Tetanus toxoid conjugates of the deprotected tetrasaccharide hapten 21, where sulphur replaces oxygen in the terminal non-reducing glycosidic linkage were also used as an immunogen. The immune response to this modified antigen raised high titre sera that reacted with the corresponding O-linked tetrasaccharide-BSA conjugate and with the C. albicans native antigen (Figure 3). Although the fidelity of the recognition for the native O-linked antigen was surprisingly high by sera raised to the S-linked antigen, the titres of this sera were nevertheless slightly lower than titres for sera raised against the homologous O-linked epitope. As a prelude to active challenge experiments in an animal model of C. albicans infections, we sought to establish whether the antibodies raised to synthetic vaccine constructs were able to recognize the β-mannan antigen displayed on the cell wall of C. albicans. Anti-sera to conjugate vaccines constructed from trisaccharide 5 and both O-linked and S-linked tetrasaccharides at dilutions ranging between 1:1,000-10,000 were all able to bind the native βmannan when present on the cell wall of C. albicans. The experiment involved detecting antibody labeled cell wall with a fluorescein labeled goat anti-rabbit antibody. The labeling experiments showed that the β-mannan could be detected on both Candida hypia and budding cells. These labeling experiments provide promising evidence that a vaccine designed to generate antibodies to the β-mannan should have potential as a therapeutic vaccine in agreement with data generated in mice to a related vaccine created from isolated cell wall components (23,24). Preliminary data from our ongoing experiments suggest that rabbits immunized with a trisaccharide-tetanus toxoid conjugate show an increased ability to clear Candida albicans. The results of these ongoing studies will be the subject of forthcoming manuscripts.



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Scheme 6. Efficient process for large scale synthesis of βΐ,2-linked mannans

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Scheme 7. Preferred strategy for conjugation of oligosaccharide to protein carrier.

R = trisaccharide 26

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Ν Η

R = trisaccharides 5 a n d 9, tetrasaccharides 12 a n d 21, pentasaccharide 13 and hexasacharide 14.

2

R-Q(CH )3S(CH )


180


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4

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Figure 3. ELISA titration of rabbit serum against an extract of native βmannan; • rabbit immunized 3 times with a tetrasaccharide-tetanus toxoid conjugate, and • rabbit immunized 3 times with a thio-tetrasaccharide-tetanus toxoid conjugate. Both antigens were given with Freund's adjuvant.

Experimental Antigens Glycoconjugates were synthesized as previously described (31-33). The tetanus toxoid conjugates were dissolved in phosphate buffered saline (PBS). BSA conjugates were dissolved in PBS and used to coat ELISA plates.

Immunization Protocol A: tetanus toxoid conjugate (50 μg) was diluted in 500 μ ι of PBS and mixed with 500 μ ι of Freund's complete adjuvant or with 500 μΐ, of Freund's incomplete adjuvant. Each rabbit was injected with 1ml of vaccine: 0.5 mL intramusculary in one rear thigh and 2 χ 0.25 mL at subcutaneous injections. Three injections were given at monthly intervals. For the second and third injections, the antigen was given in Freunds incomplete adjuvant. Rabbits were bled 9 days after the last injection.



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Figure 4. ELISA titration of a rabbit serum on trisaccharide-BSA coated plates: antibody titers achieved by two injections of the trisaccharide-tetanus toxoid conjugate are representative of rabbit responses. Dashed lines are titration curves ofpre-imune sera

Protocol B: The trisaccharide-tetanus toxoid conjugate (0.5 mg) was dissolved in 0.5 mL of PBS, 2 mL of alum suspension was added and the sample was rotated for 1 hour at ambient temperature. To maintain sterility 250μg of thimerosal at 10mg/ml was added. Rabbits were immunized with the antigen absorbed alum suspension (0.5 mL /rabbit) distributed over 5 sites (0.1 mL/ site). Two injections were given intramuscularly in the rear thigh and 3 subcutaneously along the back.

Enzyme Immunoassays Antibody levels in sera were established by ELISA experiments utilizing trisaccharide BSA conjugates coated on 96 well microtitration plates. Carbohydrate-protein conjugates (10 μg/mL; 100 μ ί ; 4 °C, overnight) were used to coat 96-well ELISA plates (MaxiSorp, Nunc). The plate was washed (Molecular Devices Skan Washer 400) 5 times with PBST (PBS containing Tween 20, 0.05% v/v). Sera were diluted with PBST containing 0.15% BSA and the solutions were added to the plate and incubated at room temperature for 2 hours. The plate was washed with PBST (5 times) and goat-anti-rabbit IgG



182 antibody conjugated to horseradish peroxidase (Kirkegaard & Perry Laboratories; 1: 2000 dilution in PBST) was added (100 μ ί ) and incubated for a period of 1 hour. The plate was washed 5 times with PBST before addition of a 1: 1 mixture of 3, 3', 5, 5'-tetramethylbenzidine (0. 4 g/L) and 0. 02% H202 solution (Kirkegaard & Perry Laboratories; 100 pL). After 2 minutes the reaction was stopped by addition of 1 M phosphoric acid (100 pL). Absorbance was read at 450 nm (Molecular Devices Spectra Max 190 plate reader). C. albicans mannan was obtained by 2-mercaptoethanol extraction of whole cells without subsequent affinityfractionation(23) and was dissolved in PBS (10 Mg/ml), and the solution was used to coat 96-well ELISA plates (100 μΐ/well, 18 h at 4 °C). Plates were washed five times with PBST and blocked for 1 h at room temperature (2% bovine serum albumin/PBS, 100 μίΛνεΙΙ). The dilution of sera at which a significant absorbance reading above background (~OD = 0.2) is recorded at the antibody titer.

Acknowledgements We thank the Natural Sciences and Engineering Research Council of Canada (NSERC), the Canadian Institutes of Health Research (CHIR) and Alberta Ingenuity for support of this work.

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